32A-152 (6) 07/18%1994 04:28 4135829973 HAMPSHIRE PROP MGMT PA,3E 01
i cr tnua 1�:[: 41 i-5'L/-tl4b5 RCI ROOFIII
R C-i. Wfi
P O. DO- 309 - 40 Maine Avenue
tlasthamptcx+, MA 0102.7
Phunc 1J 3-317-4'x'7!) >?ax. 523-'527-Ei•�d9
CONTRNCT
This agreement made As of the date indicated below, by and between the contractor and
Hampshire Property Management Group (OWNER).
CONTRACTOR: R.C.I. Roo49ng
ADDRESS: 40 Maine Avenue - P.O. Box 309 - Easthampton, MA 01027
PHONE: (413) 527-4775
OWNERS: Mark Delisle/Chris Thompson
FED. ID M: 04-3418839
H.I.C. UC. a`: 126 235
CONST. SUPER. LIC.A: 074 334
PROPERTY NAME: Hampshire Property Management Group
PROPERTY ADDRESS: 5.7 Strong Avenue/ Northampton, MA
PROPERTY PHONE: (413) 582-91970 X 101
PROPERTY REPRESENTATIVE: Rich Madowltz
The contractor agrees to furnish both labor and materials to complete the work as specified
In the attached proposal for the sum of($13,200.00)the payment of which is to be made as
follows: 90% ($11,880.00) due upon completion and 10% ($1,320.00; due upon receipt of
warranty,
All material Is guaranteed to be as specified. All work will be Completed in a professional
manner according to standard practices. Any alterations or deviation from the above
specifications will be performed only upon the written agreement with owner for welch an
extra charge over and above the agreement price may apply. This agreement is contingent
upon strikes, accWents or delays beyond the control of the contractor. The contractor Is
fully covered by workers Compensation Insurance and any other Insurance coverage required
by law. Documentation will be furnished upon request. The owner Is to carry fire and other
necessary Insurance to cover his property,
THIS CONTRACT!HALL 62 `i[NOING UPON BOTH THE CONTRACTOR AND THE
OWNER/ AUTHORIZED REPRESENTATIVE UPON AFIXING THEIR SIGNATURES AND
DATES WHERE INDICATED BELOW. tap NOT SIGN THIS CONTRACT IF THERE ARE
ANY BLANK SPACN.
Contractor: Owner/A.uthoCized ReoMsel3tatly e
Signature: Signature:
Date: ila.12-03 Date: j_LjI-%.7a� r ice• t�rr
NOTICE: T'he owner has the right to cancel the contract within (3) three business days of
date of slgning.
A y E �ZasaRrhncrtts' =
i —
c� DEPARTME14T OP BUILDr�,,C INSPPCT101.'S —
212 Main Strcct ' Municipal Duilding
Northampton, Mass. 01060
«'ORICCIZ'S COKPFNSATION lgStJRANCE AF I AV1-J.'
@ �.
(liccnsc&permlttcc) J
\k',th a prirtcipaJ place of business/residence at:
J40AdInP.Ate.it Fas+ (St=an MA Ol�a�1 (phone') _�7q5
do hereby certify, under LhC pasru and penalties of perjury, hal
(�) I m an employer providing the followine workcr's comocnsa io l covervgc for ink
eluplovecs workng on'uvs job:
t i h Lj 'It l al VULWS 317121-033 101 s l og .
mot~ Corer ) (Policy Nunalrcr) (.:,jimnon Dal.:)
O I,am a sole proprietor, geoeraJ coou-actor or homeowner (ci:cie one) and have hired
the coasactors bs-tecf below rqbo have the folloxviog workers coMpefisation policies:
(Namc of Co.^.,mcior) Ons-ur ic-- Compa l)'/hour (t?:JM,3'u0n Ditc)
(Namc of Cootraclor) Rrisuran= Compa.ay/PoUm, Numb-:r) (—L.xpiraon Duc)
(Nair of CConnaelo,) (Insurance Compao}•/Policy Number) (Expiroon Date)
Namc of Conaactor) (Lasuran= Compacy/Poucy Numbcr) (Expi m600 Dart).
(atsi.cb ad"i'.;oczl chca ifnoocaay to indudc iafortaa�oo pcztaiaia6 to.L ooa7a.cors)
( ) I am a sole proprietor and have no one working for me.
( ) I atm..a home owner performing all the work myself.
NOTE:plesc be ewxm the w't�_.Je bomeo..vcn wtbo cmploy pcswa Lo do=A.,r�ec�-4ajoo r repmLir-ork oa.d.,xWnz of
oa mocc t!L n ! w--j is wbi the bocnoowoc rcvdo or oo Lb.p•ouod3 zppur�tbeen,ox C="-%Dy occ&rrJ to be
cmPloy,z.-,,, the�= crz o=Pcalica Aa(GL152-=1(5)�aPpUCL600 try a bomeoata for a 6c—.c cc permit=y e%ideaoe the
1 c rU1u of ea esployer uader dao Wocic,olc C.Oc e.�t Ad.
1 uadc uzd tha a oopy of tbu mrcmaai m.y bo focword..d to the D.,,,- ttor or 14i.l Modems'orrioo or 4nur.ncu for th.
oovc gc`rmL=w=W th1 U-=to smsrc tiovcrxZc=dcr sccuoo 25 A of MOL 152 can lad to the impxisiioo orciminal PC-
Iii-00—Mg of a Lac or up to S 1,00.00N or up to coc ycar tad c%-1 pcoario in t5c form of a Slop Wort Order Lad a
fim 0(5100.00.day aptiaA tnc
For dry+rttz.:.'.sl ux only
Pcrm,l Numbcr
r'
Y
Sil; balrt of Li=scclPcrmiLt= 'IS to hen __ Lot Y
JI Version 1.7 Commercial Building Permit May 15,2000
SECTi0N;1 51Rl1CTUR L PEER REVIE f 780 CM R 111011
Independent Structural Engineering Structural Peer Review Required Yes......❑ No......❑
SECT#QN' 11$-,`OWN: ERgUT1i0RIZATION 7�BE:COMPLETED WHEN
OWNERS AGENT,5 C NTiRACTOR APPLIES FOR2 BUILDIM PERMIT
1�
I, .1dL SL.LY)2 as Owner of the subject property
hereby authorize %,Xaa� -De-h5b2, iL•G•1. Rohfma to act on
my behalf, in all matters relative to work auhorized by this buildin ermit application.
ntltaeh A I a -17-03
Signature of Owner Date
I, \C�x�� as Owner/Authorized Agent
hereby declare that the statements and information on the foregoing applicati re true and accurate, to the best of my
knowledge and belief.
signed under the pains and penalties of perjury.
Print Name
Signature of Owner/Agent Date
SECTION 12:-CONSTRUCTION SERVICES ,
10.1 Licensed Construction Supervisor: Not Applicable ❑
M
Name of License Holder: � ` LE \\SA�,. 0-1 t it a
License Number
Addres Expiration Date
s
` -� `7-LA
Signature Telephone
SECTION;13 WORKERS' COMPENSATION #NSURANCE,AFFIDAViT(M G 1:.x.152,§25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit
will result in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... ❑ No...... ❑
' Version 1.7 Commercial Building Permit May 15,2000
;SECTION PROFESSIONAL DESIGN AN.D CONSTRUCTION SERVICES FOR BUILDINGS'AND STRUCTURES S[IBJEC 'TO -
t? iSTRUCTION CO;NTROL;,PURSUANT TO 780;CMR 116(CONTAINING 'MO2E>THA,N`35Ob0,3C F ill'EMCLOSED SPACE„ ,
9.1 Registered Architect:
Not Applicable
Name(Registrant):
Registration Number
Address
Expiration Date
Signature Telephone
92 Registered Professional Engineer(s):
NIA
Name Area of Responsibility
Address _ Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
9.3 General Contractor
Not Applicable
Company Name:
Responsible In Charge of Construction
Address
Signature Telephone
Version 1.7 Commercial Building Permit May 15,2000
7.Water Supply(M.G.L.c.40, §54) 17.1 Flood Zone Information: 17.3 Sewage Disposal System:
Public ❑ Private ❑ Zone: Outside Flood Zone ❑ Municipal ❑ On site disposal system ❑
8. NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg. Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained Date Issued:
C. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ?YES
No
IF YES, describe size, type and location:
Version 1.7 Commercial Building Permit May 15,2000
SECTIbN 4CONSTRUCTiOI SERVICSFB �PROJEC7S'LESS THAN 35;000 r
CUBIC�El=r, F TNCLO ED3$PACE ,
r
nti
.. .-•' ...r_ ( r .n 3"k aA '. is'Fi 3PA,,,,_ >;*,.� > ,L 3 l
Interior Alterations Existing Wall Signs Existing Ground Signs Additions ❑ Roofing
❑ ❑
Exterior Alterations Demolition❑ New Signs [ ] Change of Use [ ] Other [ ]
❑ Accessory Building[ ] Repairs [ ]
tRiemoxe. exiSilr� rnembr m, roof.
DESC2P�r 1n
SECTION$ k 11SE GROUP AND CbNS UGTIQ
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly 10 A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 1 B ❑
B Business ❑ 2A ❑
E Educational ❑ 2B I ❑
F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
Institutional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B ❑
M Mercantile ❑ 4 ❑
R Residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑
S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
U Utility ❑ Specify:
M Mixed Use ❑ Specify:
S Special Use ❑ Specify:
CDMPL'ETE'TH,IS SEMI'ON IF EXISTING BUILDING UNDERGOING RENOVATIONS.RDp1TlONS.AND/0R;CHANGE IN USE
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
SECTION 613UILDINGlli,,HEIGHT A ND AREA+
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTIONi ��i <� ����, ��i
i 1J,Ya $T.w
Floor Area per Floor(sf) St
t
2nd
3 r
1st 2
e
3rd F Y x
2nd y 1, � gy�y
3rd 4th `x
4th
aN �
Total Area (sf) Total Proposed New Construction (sf)
.................................... % z
Total Height(ft)
Total Height ft -------------------- 9 sr
Version 1.7 Commercial Building Permit May 15,2000
r
City of Northampton
43
Building Department
9 � 212 Main Street
Uv 2 Room 100
Northampton, MA 01060
I att;a`` 13-5$,7,,40 Fax 413-587.1272
a.
APPLI.GATION TO CONSTRUCT, REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1 SITE INFORMATION
Thrs sec#�o #o becempd ,f �
1.1 Property Address:
�o i
� s � � n
SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
,Na p-,6-f& ProOeXtu-M anaAe on-r P.0• Cox b86 - �yii mpjon
Name(PA t) U Current Mailing Address:
GZ`rh� (H13) 58 a,-8970
Signature Telephone
2 2 Authorized Agent: QQ
\ 0 (�C7 `3091 C-asNN v,n- ,a. (Xu-.
Name(Print) Current Mailing Address:
Signature Te phone
SECTION 3' ESTIMATED`CON5TRUCTION'COST5
Item Estimated Cost(Dollars)to be 'Official UseDrIiyi`
D
completed b permit applicant
1' g i�00�1n 13, a00.b0 (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from'. 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 + 2 + 3 +4 + 5) 46 1,j, oW D.Oc-) Check Number
TMi�s,te'cttnrw'"for Official Use:Dnl
8fdtfitg Fermat lyumber:
r:
Date Issued:
Ow
��
Slgnature
y ,
ui ding Corti assigner/.Inspector of Butld�ngs. i pate .:
5 STRONG AVE BP-2004-0709
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 32A- 152 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2004-0709
Project# JS-2004-1030
Est.Cost: $13200.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: RCI ROOFING 074334
Lot Size(sa.ft.): 3746.16 Owner: TRIDENT REALTY CORP
Zoning: CB Applicant: RCI ROOFING
AT: 5 STRONG AVE
Applicant Address: Phone: Insurance:
P 0 BOX 309 (413) 527-4775 Workers
Compensation
EASTHAMPTON MAO 1027-0309 ISSUED ON:12130103 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL NEW MEMBRANE ROOF
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType• Receipt No: Date Paid: Check No: Amount:
Building 12/30/03 0:00:00 4935 $50.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo